Nerves of the Hip and Thigh

The joints and muscles of the hips and thighs need nervous input so they can do what your brain wants them to do. The muscles also require a lot of blood flow, which provides oxygen and nourishment, especially when you’re physically active.

The following nerves serve the gluteal and thigh regions:

Superior clunial nerve (L1–L3): This nerve starts from the 1st through 3rd lumbar spinal nerves and crosses the iliac crest to supply to the skin over the buttocks.

Middle clunial nerve (S1–S3): Starting from the 1st through 3rd sacral spinal nerves, this nerve runs to the gluteal region to supply the skin over the buttocks.

Inferior clunial nerve: This nerve branches from the posterior cutaneous nerve of the thigh to the inferior border of the gluteus maximus. It also supplies the skin over the buttocks.

Sciatic nerve (L4–S3): This nerve branches from the sacral plexus and passes through the greater sciatic foramen to enter the gluteal region. From there it traverses underneath the biceps femoris and splits into the tibial and common fibular nerves at the knee. It innervates the muscles of the posterior thigh.

The sciatic nerve is the longest and widest nerve in the human body and can quite literally cause a pain in the butt when it’s compressed by a herniated disc or sometimes by the piriformis muscle. The pain, along with burning, numbness, and tingling sensations, may also be felt in the lower back and down the back of leg on the affected side. This condition is called sciatica and can be treated with ice packs, special exercises, and nonsteroidal anti-inflammatory medications. It may also help to avoid sitting positions for long periods of time.

Posterior cutaneous nerve of the thigh (S1–S3): Beginning at the sacral plexus, this nerve runs through the greater sciatic foramen and under the gluteus maximus before traveling down the thigh deep to the tensor fasciae latae. It innervates the skin of the buttock, posterior thigh, and calf. It also has a perineal branch that innervates the perineum and upper medial thigh.

Superior gluteal nerve (L4–S1): This nerve runs from the sacral plexus through the greater sciatic foramen and between the gluteus medius and minimus. It innervates those two muscles along with the tensor fasciae latae.

Inferior gluteal nerve (L5–S2): Running from the sacral plexus though the greater sciatic foramen, this nerve then divides into several branches that innervate the gluteus maximus.

Nerve to quadratus femoris (L4–S1): This nerve runs from the sacral plexus through the greater sciatic foramen and innervates the hip joint, inferior gemellus, and quadratus femoris.

Pudendal nerve (S2–S4): This nerve runs from the sacral plexus through the greater sciatic foramen and enters the perineum through the lesser sciatic foramen. It innervates the perineum.

Nerve to obturator internus (L5–S2): Running from the sacral plexus through the greater sciatic foramen, this nerve enters the lesser sciatic foreman to the obturator internus. It innervates the superior gemellus and obturator internus muscles.

Three nerves run through the region of the anterior and medial thigh:

Femoral nerve (L2–L4): This nerve runs from the lumbar plexus along the psoas major past the inguinal ligament to enter the femoral triangle. It has branches that innervate the anterior thigh muscles and the hip joint.

Obturator nerve (L2–L4): This nerve runs along the psoas major through the obturator foramen, where it divides into anterior and posterior branches. It innervates the adductor longus, adductor brevis, gracilis, pectineus, obturator externus, and adductor magnus.

Saphenous nerve: This nerve is the terminal cutaneous branch of the femoral nerve. It accompanies the femoral artery and innervates the skin and fascia of the knee, leg, and foot.